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Senate candidate Stephen Lynch: I support national public option for health insurance, but state-run public option best for Massachusetts

Stephen Lynch

Democratic U.S. Rep. Stephen Lynch said Thursday night that he supports a national public option, a government-run health insurance plan. It’s the first time Lynch, who opposed President Barack Obama's Affordable Care Act and has a complex history with the issue, has articulated his support for a national public option.
(Photo by Charles Krupa / Associated Press [file])

... a national public option would be better than no public option. ... You can’t let the perfect be the enemy of the good.

Democratic U.S. Rep. Stephen Lynch said Thursday night that he supports a national public option, a government-run health insurance plan, and said the lack of a public option is one reason he opposed Democratic President Barack Obama’s health care reform.

While the Affordable Care Act was being debated in 2009, Lynch was criticized by unions and health care activists for remaining non-committal on the public option until days before the vote on the bill. In 2010 and again several weeks ago, Lynch said he supported a public option on a state level. Thursday’s statements appear to be the first time Lynch has clearly articulated his support for a national public option, a policy that could help Lynch appeal to Democratic voters as he faces U.S. Rep. Edward Markey in the Democratic primary for U.S. Senate.

“I think the best arrangement for Massachusetts is a state-run public option. I do believe that,” Lynch said in a phone interview with MassLive.com. “But a national public option would be better than no public option. It would be better than no competition. You can’t let the perfect be the enemy of the good.”

As recently as Feb. 11, when Lynch spoke at a New England Council breakfast, he said the Affordable Care Act had two models for a public option – a state-based one and a national one. “The national public option, if it was adopted, and I opposed that, would have required us to reconcile the cost of our health care and what was going on in Massachusetts with what is going on in Arkansas, and Tennessee, and Mississippi, and parts of South Carolina, and it wouldn’t be good,” Lynch said. “They weren’t going to boost those people up to our level. They would drag us down to theirs.”

Asked about those comments Thursday, Lynch said he believes a state-based public option is better, but he would support the national public option. “I voted for it. How do you explain it any other way?” he said.

Lynch has a complex history with the public option and the Affordable Care Act. He voted for an early House version of the bill, but against the final bill.

During the heat of debate, in September 2009, Lynch voiced skepticism about the public option. At a town hall in Milton, according to an audio clip posted on the website Open Media Boston by the independent I.B.I.S. Radio, an attendee said she supported a public option that would act like Medicare. Lynch responded that while Medicare does a good job, it “does not reduce health costs in general.” He said while a public plan would ideally force private insurance costs down, there has been no evidence of that happening. “We have no history in our current experience with Medicare or with any other publicly provided program that has exercised downward pressure on private insurers,” Lynch said.

Asked about those comments Thursday, Lynch said a public option would not guarantee lower prices, but “it’s a guarantee if you don’t have a public option, if you don’t have competition, the prices will be high.”

Over Labor Day weekend 2009, the Boston Globe reported that Lynch, then considering a U.S. Senate run, was barred from speaking at a Greater Boston Labor Council breakfast because of “his skeptical stance toward a new government insurance program.”

The same day, at a pro-health care rally organized by Obama’s political organizing group, the Globe reported that Lynch was booed because he expressed skepticism about the plan’s price tag, and labor unions saw him as being opposed to a public option – even though Lynch said at the rally that he favored reform.

“Lynch got booed off the stage,” recalled Richard Kirsch, then national campaign manager of the pro-health care reform advocacy group Health Care for America Now. “The rest of the Massachusetts delegation was cheered and welcomed. He was jeered.”

With Lynch’s position uncertain, the pro-health care reform advocacy groups Health Care for All and Community Catalyst targeted Lynch’s congressional district with flyers touting the benefits of the reform. “He was a target for us,” said Robert Restuccia, executive director of Community Catalyst. “We felt he was not a strong supporter of the Affordable Care Act and needed as much shoring up as possible.”

Restuccia said Lynch did not raise the issue of the public option then. “Our assumption at the time, and his rhetoric made it clear, he was opposing it from the right,” Restuccia said. “(The public option) was not the issue he was bringing up in relation to this.”

In July 2009, Lynch told the Boston Herald that he supports the concept of a public option but wants to know how it will be paid for. That September, the Boston Globe and the Patriot Ledger of Quincy both reported that Lynch remained undecided on the public option and would not take a position on it. In late October 2009, Lynch told a Georgetown University forum that there would be some element of a public option in the House’s proposal and “we need something that is robust enough to compete with the private plans.”

On Nov. 7, 2009, Lynch voted with most House Democrats in favor of the House version of the health care reform bill, which passed 220 to 215. That version included a public option.

Lynch said at the time that the bill would expand health care coverage while taking steps to manage costs. He pointed to its benefits prohibiting insurers from denying coverage because of a pre-existing condition and providing portability of health care coverage. He did not mention the public option in his public statement.

When the House passed the final version of the bill on March 21, 2010, Lynch was one of 34 Democrats to vote against the bill, which passed 219 to 212.

Lynch said at the time that the bill “cost almost a trillion dollars but…offered little to reform the current skyrocketing costs of the fee-for-service system that is dominated by the insurance industry.” Lynch said he opposed the bill because it did not repeal an antitrust exemption that allowed insurance companies to operate as monopolies and it taxed high cost health plans rather than high income individuals – which could hurt union members. He said it did not include a provision from the House version that “allowed each State to establish a true public option with the object of offering low-cost insurance plans, thereby forcing insurance companies to compete.” Those are the same objections Lynch continues to provide today.

Activists on both sides of the health care debate said a state-run public option was not being discussed at the time; a national public option was.

Activists say that did not appear to be the focus for Lynch. Josh Archambault, director of health care policy for the conservative Pioneer Institute of Public Policy Research, said he recalls Lynch’s focus on cost containment. “I personally give Congressman Lynch some credit for acknowledging this is a very complex issue with a very different impact on a state like Massachusetts compared to other states,” Archambault said.

Even if a public option were the issue, Lynch’s support for one is unlikely to quiet all his critics, who say Lynch made the perfect the enemy of the good in opposing the bill. “The thing I think is important is ... he voted against the legislation that provided health care for tens of millions of people, that stops companies from denying care for pre-existing conditions,” Kirsch said. “The fact that the final legislation didn’t have a public option was no excuse to vote against it.”